一期双膝关节单髁置换围手术期风险评价研究  

Perioperative complications of bilateral single-stage unicompartmental knee arthroplasty

作　　者：涂意辉[1] 马童[1] 薛华明[1] 文涛[1] 蔡珉巍[1] 

机构地区：[1]同济大学附属杨浦医院,上海200090

出　　处：《生物骨科材料与临床研究》2016年第6期17-19,24,共4页Orthopaedic Biomechanics Materials and Clinical Study

基　　金：上海市卫生局重大科研项目(2013040);上海市科委引导类项目(134119b1400)

摘　　要：目的评价膝关节双侧同期单髁置换与单侧单髁置换的围手术期安全性。方法回顾性分析2008年1月～2014年12月采用膝关节单髁置换术治疗膝关节内侧间室骨性关节炎患者231例（273膝），其中双侧同期手术（Single-stage，SS组）42例（84膝），单侧手术（Unilateral replacement，UR组）189例（189膝）。记录引流量、术前术后血色素、麻醉时间、止血带时间、并发症率和死亡率。结果所有患者无死亡、脂肪栓塞、心脑血管意外、肺栓塞或假体感染严重并发症。术后有5例浅表感染，2例术后手术侧肢体皮下瘀斑，4例静脉血栓。ss组平均麻醉时间（119．3分VS77．3分，t=21．60，P〈0．05）和平均止血带时间（98．5分VS55．2分，t=-19．87，P〈0．05）要长于UR组，术后血色素两组无统计学差异（t=1．54，P=0．124），无需输血病例。结论双侧同期膝关节单髁置换术相对单侧单髁置换术并不增加并发症发生率和死亡率。Objective To evaluate the clinical effectiveness and rates of perioperative complications between bilateral single-stage and unilateral unicompartmental knee arthroplasty （UKA）. Methods Between Jan 2008 and Dec 2014, we compared a prospective series of42 single-stageUKAwith 189 unilateral UKA for OA. Complications, operative times, tourniquet times, amount of drainage and hemoglobin （Hb） were evaluated. Chi-Square test, Fisher＇s Exact Test, paired and grouped t-test. The significance level was set at P≤0.05. Results No complications of death, fat embolism, pulmonary embolism, and prosthetic infections were established. Superficial infections occurred in 5 cases. Subcutaneous ecchymosis occurred in 2 cases. Four patients had a distal vein thrombosis. Patients who underwent single-stage UKA had a longer cumulative anesthesia time （119.3 versus 77.3 minutes, P〈0.05） and tourniquet time （98.5 versus 55.2 minutes, P〈0.05）. There were no significant differences between two group regarding the pre- and postoperative Hb levels, and no patient required blood transfusion. Conclusion These results show that The single-staged UKA can be performed without incre- asing perionerative mortality or comnlications.

关 键 词：关节置换术 单间室 双侧 同期 

分 类 号：R687.4[医药卫生—骨科学]